Step-oblique mammography

Step-oblique mammography is an accurate technique for determining whether a mammographic finding visible on multiple images on only one projection (but not elucidated using standard additional mammographic projections) represents a summation artefact or a true mass and for precisely localizing the true mass for further evaluation. 

Projections are obtained every 15° beginning with the view in which the density is visible. If the density is still not visible with this technique, it can be considered a summation artefact, and no further evaluation is needed.

The diagnostic accuracy of step-oblique mammography will be maximized by carefully observing technical requirements.

  • all step-oblique images should be taken with the breast in the same orientation (i.e. all mediolateral oblique or all lateromedial oblique)
  • the nipple should be in profile on all step-oblique exposures and there should be no rolling of the breast .
  • the patient should stand up straight during all step-oblique exposures.
  • projections are obtained every 15° beginning with the view in which the density is visible
  • frequently used to assess the non-calcified density identified on only one standard mammographic projection
  • helpful in evaluating grouped microcalcifications seen on only one standard view
  • helpful in establishing the presence of truly clustered calcific particles
  • permitted accurate three-dimensional localization of the lesion
  • step-oblique mammography is also useful in indicating the three-dimensional locations of more than one lesion in the same breast, especially if two or more lesions display similar mammographic features and are similar in distance from the nipple; confirmation of the precise three-dimensional location of each lesion by step-oblique mammography permits planning of the optimal approach for imaging-guided biopsy.
  • if the density is not visible with this technique, it can be considered a summation artefact, and no further evaluation is needed

It was initially described by K L Pearson et al.

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Article information

rID: 28203
System: Breast
Synonyms or Alternate Spellings:
  • Step oblique mammography
  • Step oblique mammographic technique
  • Step-oblique mammographic technique

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